Fenoverine-induced rhabdomyolysis

Abstract

Fenoverine is a spasmolytic drug that inhibits calcium channel currents. We describe the clinicopathologic find ings in two patients with fenoverine-induced rhabdomyo lysis, of whom one died. A transient left-bundle-branch block was observed in both patients. In one case, pre-exist ing hepatic dysfunction may have induced accumulation of the drug. Concurrent treatment by fibrates, as observed in the second patient, may have been a predisposing factor for fenoverine-induced rhabdomyolysis. The incidence of muscular complications of fenoverine therapy could be reduced by avoidance of prescription of the drug in patients with hepatopathy or those being treated with cho lesterol-lowering agents. Physicians should be aware of life-threatening adverse effects of apparently innocuous drugs.

Keywords

fenoverine rhabdomyolysis ischemia spas molytic drug

Get full access to this article

View all access options for this article.

References

Camarri E. Fenoverine: smooth muscle synchronizer for the management of gastro-intestinal conditions. II. A trimebutine-controlled, double blind, crossover clinical evaluation. Curr Med Res Opinion 1986 ; 10: 52-57.

Anonymous. Fenoverine. In: Reynolds JEF, (ed). Martindale: the Extra Pharmacopeia. 29th edn., London, The Pharmaceutical Press, 1989: 1571.

Mironneau J. , Arnaudeau S. , Mironneau C. Fenoverine inhibition of calcium channel currents in single smooth muscle cells from rat portal vein and myometrium . Br J Pharmacol 1991; 104: 65-70.

Chichmanian RM , Spreux A. , Bouillet M. , Chiffoleau A. , Baudot S. , Larousse C. Rhabdomyolyses dues à la fénovérine: analyse de 45 cas. Rev Méd Interne 1992; 13: S114.

SpasmoprivR. (fenoverine) , In: Dictionnaire Vidal, 69th edn, Paris, Editions du Vidal , 1993: 1314.

Chariot P. , Benbrik E. , Schaeffer A. , Gherardi R. Tubular aggregates and partial cytochrome c oxidase deficiency in skeletal muscle of patients with AIDS treated with zidovudine. Acta Neuropathol (Berlin) 1993 ; 85 : 431-436.

Hu Oyp et al. Determination of fenoverine, a modulator of smooth muscle motility, in capsules and in human plasma: application to dosage form stability and a pilot study in humans. J Pharm Sci 1992; 81: 91-93.

Ratiney R. , Astier A. , Chariot P. Determination of fenoverine in tissue samples by high-performance liquid chromatography. J Chromatogr B 1994 ; 654: 159-163.

Sultan S. et al. Rhabdomyolyse aiguë à la fénovérine (Spasmopriv): un cas et revue de la littérature. Thérapie 1992; 47: 433-447.

10.

Lacroix P. et al. Activité comparée de l'ethavérine et de la papaverine sur les fonctions cardiaques chronotrope et dromotrope chez le chien anesthésié . Arch Int Pharmacodyn 1976; 221: 163-176.

11.

Benamouzig R. et al. Rhabdomyolyse aiguë et entérocolite nécrosante survenues après la prise de fénovérine. Gastroentérol Clin Biol 1992; 16 : 719-720.

12.

SpasmoprivR. (fenoverine) , In: Dictionnaire Vidal, 71th edn, Paris, Editions du Vidal , 1995; 1394.